Adonis Diaries

Posts Tagged ‘nocebo

Are you familiar with the nocebo concept? Is worse to accept than the than placebo?

Considering the nocebo

The letter to the co-op board sounds likely enough. The tenant is up in arms because air fresheners and other common household odors are seeping into the writer’s apartment, giving him severe migraines. What to do about this chemical onslaught?

There’s no doubt that these odors are giving the letter writer a debilitating headache, but also little doubt that there isn’t a likely double-blind, testable, organic chemistry cause to the headache only in this setting.

The migraine in this case, like many things that bother us, is caused by a nocebo.

A nocebo is a placebo that makes things worse.

In this case, the lack of control over his home, the unwelcome and unasked for odors, are making him feel trapped, and thus annoyed, and angry, and so they lead to a headache.

It’s pretty clear to most of us that if that very same bundle of molecules wafted in the door when the clever and happy grandson came to visit, there would be no problem.

Of course the nocebo is real. And eliminating it is a great way to improve your life or the lives of your customers.

The TSA intentionally brings a nocebo to the airport, stressing out innocent travelers. (TSA?)

And schools know precisely how to raise the blood pressure of stressed out students.

In many situations, loud noises, uncomfortable seats, moments of lost control… these create actual physical discomfort.

We can use the nocebo to give you a headache, a backache, or even a chronic degenerative disease…

But you don’t remove the nocebo with medical tests.

You remove it with a better story, with a situation that makes us feel powerful and in control, with a setting and a narrative that gives us agency and dignity.

[I’m not asserting that all migraines are caused by nocebos. Far from it. I apologize to anyone who got that impression. But there’s plenty of evidence that there are very real problems caused by nocebos.]

Placebo is neutral and inexpensive? Think again!

Placebo are supposed to have neutral effects in double-blind experiments on the effects of medicines, and they are thought to be very inexpensive products.

First, do you know that 80% of published peer-reviewed clinical research failed to describe the contents in ingredients and the components of placebo used in the experiments?  Fact is, placebo are not mere sugar, plain water, saline solutions… They do have ingredients “considered to be safe or neutral” by the researcher.  Remember the case of olive oil used as placebo while cod oil was the medicine of cure?  They both lowered cholesterol level!

Second, placebo are not cheap!  Placebo are usually more expensive than the actual manufactured medicine to test.  The placebo has to exactly resemble the medicine in form, shape, color, consistency, taste, credible in the logo and inscriptions… The pharmaceutical manufacturer has to redesign a new product for small quantities:  Thus, placebo are far more expensive than normally budgeted in the research grant. 

Actually, a new field is emerging for graphic designers called “placebo designers” with objective of finding creative and credible placebo.

Third, autosuggestion that placebo is the proper medicine has demonstrated to be a potent factor in the cure of many patients.  For example, in 17% of the cases when patients were informed to be taking placebo, it had a positive influence.  Fabrizio Benedetti used saline solution on Parkinson patients.  The activities in the corresponding cerebral region diminished significantly:  The trembling ceased.

Do you know that between 2001 and 2006, the number of “faked medicines” on the market that didn’t reach phase 2 in the testing (limited number of patients experimented on) increased 20%?  That marketed faked medicines that didn’t pass phase 3 increased 11%?

Do you know that the Canadian Journal of Psychiatry revealed in April 2011 that 20% of medical practitioners administered placebo on their patients without the knowledge of the patients?  That 35% of the prescribed medicines had low weak doses of potent ingredients?

Using placebo in chronic patients, familiar with the taste and consistency of the real medicine, generate negative counter-reactions in the mind of patients and called “nocebo”:  The chronic patients are no fools and can discriminate a placebo from normal medicines; they are used to taking regularly particular medicines. 

The role of autosuggest is very important in curing patients.  Consequently, unless the clinical experimenter is thoroughly aware of the types of illnesses that can be cured by autosuggest, if he fails to factor-in this variable in controlling the experiment, the results would be confounding:  Further investigations, analysis, or redoing the experiment with a reviewed design would be required.

Note:  Idea extracted from an article in the “Courrier International”


adonis49

adonis49

adonis49

October 2020
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